2256. Racial and Socioeconomic Disparities Evident in Inappropriate Antibiotic Prescribing in the Emergency Department

作者：Eili Klein, Mustapha Saheed, Nathan Irvin, Kamna S. Balhara, Oluwakemi Badaki‐Makun, Suprena Poleon, Gabor D. Kelen, Sara E. Cosgrove, Jeremiah S. Hinson · 发表于：Open Forum Infectious Diseases · 年份：2023 · DOI：10.1093/ofid/ofad500.1878 · 被引用次数：1 · 研究领域：Healthcare cost, quality, practices、Child and Adolescent Health、Healthcare Systems and Technology

Abstract Background Inappropriate antibiotic prescribing for acute respiratory infections is a common source of low-value care in the emergency department. Racial disparities have been noted in episodes of low-value care, particularly in children, but the intersection between race and socioeconomics in inappropriate prescribing has received less attention. Decisions to prescribe antibiotics outside of guideline recommendations may result from underlying bias. We evaluated inappropriate prescribing by race and socioeconomic status in five emergency departments of a large hospital system. Methods We conducted an observational analysis of antibiotic prescribing in adult and pediatric EDs at five hospitals between October 2015 and March 2023. We calculated the rate of inappropriate prescribing for ED encounters that had an ICD-10 for an acute respiratory tract infection (ARTI) that did not require antibiotics and that had no secondary ICD-10 code on the record for which antibiotics may be indicated. Multivariable regression analysis controlling for comorbidities and patient-level factors was used to estimate the odds ratio of prescribing. Results A total of 147,402 ED encounters were included, of which ∼50% identified as Black, 23% as White, and 15% as Hispanic. Inappropriate prescribing rates were 8.5% overall, 13.6% for White patients, 7% for Black patients and 6% for Hispanic patients. After adjusting for patient-level factors, including socioeconomic status,White patients had...